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Application Form

Registration Details

Application Sequence No : AYA133021890

Advertisement Number : 4385

Post Name : AYUSH Assistants

Advertisement Date : 27th December 2017

Post Applied Preference 1 : Ayurvedic Assistant

Post Applied Preference 2 : Homoeopathics Assistants

Nationality : Indian

Applicant Full Name : Mr BISWAJIT PATRA

Applicant Father's Name : Mr RAMESH CHANDRA PATRA

Applicant Mother's Name : Mrs PRATIMA PATRA

Gender : Male

10th Standard Roll Number : 65SB175

10th Standard Year Of Passing: 2010

10th Standard Board : BSE,Odisha

10th Standard Other Board : BSE,Odisha

10th Standard Exam Type : Annual

Whether passed minimum Seventh class exam. in Odia : Yes

Mobile No : 9776167026

Email Address : biswajit0518@gmail.com

Current Address

House No., Street/Lane, Village, Post Office, Police Stn, etc : AT-BARBATIA PO-BARBATIA BAZAR VIA-KAKHRA

State/U.T. : ODISHA

Distict : Balasore

City/Tehsil : BHOGRAI

Pincode : 756039

Permanent Address

House No., Street/Lane, Village , Post Office, Police Stn, etc : AT-BARBATIA PO-BARBATIA BAZAR VIA-KAKHRA
 State/U.T. : ODISHA

Distict : Balasore

City/Tehsil : BHOGRAI

Pincode : 756039

Exam City

Choice of District/City for Appearing the exam : Balasore

Other Details

Have You had "Odia" as a subject in 10th Exam : Yes

Applicant Age Details

Applicant DOB(dd/MMM/yyyy) : 18/May/1995

Age Years : 21

Age Month : 7

Age Days : 14

Category Details

Category Claimed : Socially and Educationally Backward Classes - SEBC

Sub-Caste as mentioned in Caste Certificate : RAJU

Date Of Issue SEBC Certificate : 11/Mar/2019

Special Category Details

Physically Challenged : No

Whether Ex Serviceman : No

Are you a sports person : No

In Service Details

Is Odia. Govt contractual employee : No

10th Standard Details

10th CGPA/Percentage : Percentage

10th Division : First

10th Total Marks : 600

10th Marks Obtained : 467

10th Total Percentage obtained : 77.83

Exam 10 + 2/Equivalent/Diploma Details

12th/Diploma Stream : +2 Science

12th/Diploma Board/University : CHSE,Odisha

 12th/Diploma CGPA/Percentage : Percentage

12th/Diploma Year Of Passing : 2012

12th/Diploma Division : First

12th/Diploma Total Marks : 600

12th/Diploma Marks Obtained : 431

12th/Diploma Total Percentage obtained : 71.83

Payment Details

Amount : 100

Payment Status : Payment Success

Payment Transaction No : CPQ8859977

Uploaded Documents

To view your 10th standard certificate Click here.

To view your 10th standard marksheet Click here.

To view your 12th Certificate Click here.

To view your 12th standard marksheet Click here.

To view your caste category certificate Click here.

Declaration

I hereby declare that the information given above is true to the best of my knowledge and belief . I am well aware of the fact that if the information given by me is
proved false/ not true, I will be liable for prosecution as per law.

Candidate Signature
Version 13.08.02